42例布鲁菌病的临床分析

Clinical analysis of 42 cases of brucellosis

目的分析布鲁菌病患者的流行病学特征、临床表现、诊断及治疗效果,减少临床的误诊,为布鲁菌病的临床诊断及治疗提供实践基础和经验方法。方法根据42例布鲁菌病患者的性别、年龄、牛羊接触史,发热、出汗、关节肌肉疼痛等临床表现,以及诊断及临床治疗等相关资料,对上述流行病学特征和临床表现等资料进行回顾性分析。结果患者以中年男性居多,男35例,女4例,儿童3例,全年均有发病;39例患者有明确动物接触史,其中长期饲养猪、牛、羊者38例(90.5%);主要临床表现有发热42例(100.0%),乏力32例(76.2%),肌肉和关节疼痛18例(42.9%),多汗5例(11.9%),以发热症状最为常见。其他检查显示,脾肿大29例(69.0%)。病原学检查:均为血培养阳性,培养出"马尔他布鲁菌"。患者治疗以利福平联用多西环素最常见22例(52.4%),四环素治疗10例(23.8%)。32例患者治愈、好转(76.2%),8例门诊患者用药不祥,2例出院后门诊追踪治疗。结论布鲁菌病患者以男性多见,临床表现多样化,血培养阳性可明确诊断,临床医师应加强辨别,防止误诊,并根据患者情况进行及时、有效的治疗;同时应加强布鲁菌病的监管和宣教。

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effects of brucellosis, reduce clinical misdiagnosis, and provide practical basis and empirical methods for the clinical diagnosis and treatment of brucellosis. Methods According to the data of 42 patients with brucellosis, including gender, age, cattle and sheep contact history, fever, sweating, joint and muscle pain, diagnosis and clinical treatment, etc, retrospective analysis was made on the above epidemiological characteristics and clinical manifestations. Results The majority of the patients were middle-aged males, including 35 males, 4 females and 3 children. 39 patients had a clear history of animal contact, among which 38 (90.5%) were long-term feeders of pigs, cattle and sheep. The main clinical manifestations were 42 cases of fever (100.0%), 32 cases of fatigue (76.2%), 18 cases of muscle and joint pain (42.9%) and 5 cases of sweat (11.9%). Other examinations showed 29 cases of splenomegaly (69.0%). Pathogenic examination: all were positive in blood culture, and brucella Malta was cultured. The most common 22 cases (52.4%) and 10 cases (23.8%) were treated with rifampicin and doxycycline. 32 patients were cured and improved (76.2%), 8 outpatients were given drugs ominously, and 2 were followed up after discharge. Conclusion Brucellosis patients are more common in men, with diverse clinical manifestations, and positive blood culture can be clearly diagnosed. Clinicians should strengthen discrimination to prevent misdiagnosis, and timely and effective treatment should be conducted according to the patient's situation. At the same time, the supervision and education of brucellosis should be strengthened.